Chronic kidney disease (CKD) is a public health problem in the US. Reports from the National Institutes of Health and Institute of Medicine recommend strengthening training programs for physicians in the methods of clinical research to translate advances in basic science to improvements in health. This application is to renew the training program in Epidemiology, Clinical Trials and Outcomes Research established ten years ago within the William B. Schwartz Division of Nephrology at Tufts Medical Center and Tufts University School of Medicine. Andrew S. Levey, MD and Mark J. Sarnak, MD, MS remain the Program Director and Associate Program Director, respectively. The proposed training program is unique in that it combines training by nephrologists with outstanding records in cutting-edge clinical research and by established scientists in epidemiology, biostatistics and health services research. Faculty supervision is complemented by oversight by internal and external advisors, including senior clinical investigators and world leaders in public health related to CKD. The specific aims are unchanged but their execution has been substantially strengthened by growth and maturation of research in the Division of Nephrology and the creation of the Tufts Clinical and Translational Sciences Institute, funded by the NIH: 1) Didactic Training - course work in fulfillment of the MS degree in the Graduate Program in Clinical Research at the Sackler School of Graduate Biomedical Sciences at Tufts University, with 3 new areas of concentration. 2) Independent Study - an hypothesis-based research project supervised by a nephrologist mentor and a research team of faculty with expertise in other disciplines. Nephrology faculty and their collaborators have databases and ongoing studies that can serve as the subject of the trainees' research projects, now including acute kidney injury and genetic epidemiology. 3) Training in Presentation and Publication - participation in conferences and seminars designed to improve trainees' oral and written presentations, now including experience in medical editing. Integration of all aspects of the curriculum with trainees' research projects is ensured by the nephrologist mentors. All 16 approved trainee positions in the past 4 years have been filled. An additional 14 trainee positions have been supported by other sources during this time. For 2009, 4 approved slots have also been filled; 85 applications were received for the 2 new positions. Of the 41 trainees who have completed the program since its inception, 26 have remained in academic medicine, 5 are in industry or government, and 9 have entered clinical practice and 1 is still in his clinical fellowship. Renewal of 4 training positions per year is requested for the next 5 years.